(PS5-14) Enhancing Measurement-Based Care Implementation in Opioid Treatment: Impact of Workshop Training and Ongoing Consultation

Abstract Text: Opioid treatment programs (OTPs) are at the front lines of caring for individuals with opioid use disorder, offering a combination of medication and counseling services to support recovery. Measurement-based care (MBC), or the systematic use of patient self-report measures to guide treatment, has been identified as a promising intervention to enhance OTP treatment. OTPs represent a unique context for MBC implementation, as patients receive care from a range of providers with diverse training backgrounds and often have less frequent counseling sessions compared to other behavioral health treatment settings (i.e., monthly instead of weekly). MBC implementation in OTPs requires tailored strategies aligned with provider needs and existing workflows. This project aimed to assess the impact of two implementation strategies, didactic training and monthly consultation, on provider MBC knowledge and perceived barriers to MBC implementation in the OTP context.

As part of a pilot hybrid type I effectiveness-implementation trial, treatment providers and leaders across four OTPs participated in two, two-hour MBC didactic training sessions followed by six months of monthly consultation meetings with an MBC expert focused on MBC fidelity, workflow troubleshooting, and performance feedback. Quantitative surveys were administered pre and post training to assess MBC knowledge (MBC Knowledge Questionnaire), acceptability, feasibility, and appropriateness (IAM, AIM, and FIM), practicality (ASA-MF practicality subscale), and participant demographics. Monthly consultation sessions were audio recorded and transcribed verbatim. Survey data were analyzed using descriptive statistics and paired samples t-tests to examine pre- to post-training changes. Consultation transcripts are being analyzed using directed content analysis to identify common fidelity and workflow challenges as well as barriers to MBC implementation.

Providers and leaders participated in training, consultation, and completed both pre- and post-training surveys (n = 17). Post training, participants reported a significant increase in perceptions of MBC’s acceptability (t = 2.33, p = .03) and improved knowledge of MBC (t = 2.45, p = .02), but no changes were observed in perceptions of MBC’s feasibility, appropriateness, or practicality. While qualitative analysis of consultation is ongoing, emerging MBC fidelity themes include challenges with the frequency and process of collecting MBC, sharing and acting on MBC responses, and MBC documentation. Identified workflow related challenges include identifying patients for MBC use, selecting when during treatment to implement MBC, and remembering to collect MBC monthly.

MBC is an evidence-based practice with great promise for improving treatment monitoring and patient outcomes, however OTPs likely require setting-tailored implementation strategies to support knowledge gain and fidelity. Training enhanced MBC acceptability and knowledge, however both training and consultation were insufficient for overcoming feasibility challenges faced by OTP providers and leaders. Findings suggest a need for additional implementation strategies to enhance the uptake of MBC among the diverse OTP treatment workforce.